Promoting Palliative Care for People With Heart Failure

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

1485 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-02-28

Study Completion Date

2027-06-30

Brief Summary

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This project will develop and test a novel clinical decision support tool (CDS) that encourages timely referral to palliative care for people hospitalized with heart failure. This intervention will incorporate an existing, validated 1-year mortality risk model into a CDS to deliver prognostic information and evidence-based decision support at the point of care. Thus, this research may lead to improved care-concordant and goal-directed care for people with heart failure.

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Detailed Description

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Healthcare providers will encounter the tool during the routine care of their hospitalized patients. Providers randomized to the intervention arm will receive training on the use of the tool and complete one post-trial survey. Providers randomized to the intervention arm will also have the opportunity to participate in 1 post-trial interview. Level 2 providers will participate in one interview.

Conditions

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Heart Failure Palliative Care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Providers who care for people hospitalized with heart failure at the two study sites will be recruited. Providers will be selected via retrospective chart review by study investigators. Eligibility of patients will be assessed automatically by an existing Epic build and will not involve any human intervention. When a provider opens the order entry screen of the patient's medical record, this build will examine the record for all inclusion and exclusion criteria. Those who meet criteria will be automatically enrolled and placed into a randomization group based on the randomization status of their current provider at the time of enrollment. Target sample size is 70 providers, 700-1400 participants and 15 Level 2 providers (providers potentially impacted by the tool).

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Clinical Decision Support (CDS) Tool

Providers will use the CDS tool to deliver prognostic information and evidence-based decision support at the point of care for timely referral to palliative care for participants hospitalized with heart failure.

Group Type EXPERIMENTAL

Clinical Decision Support Tool

Intervention Type BEHAVIORAL

Deliver prognostic information and evidence-based decision support at the point of care

Standard of Care

Providers will provide usual standard of care for participants hospitalized with heart failure.

Group Type NO_INTERVENTION

No interventions assigned to this group

Level 2 providers

Level 2 providers are providers potentially impacted by the tool. Level 2 providers will participate in one interview.

Group Type EXPERIMENTAL

Clinical Decision Support Tool

Intervention Type BEHAVIORAL

Deliver prognostic information and evidence-based decision support at the point of care

Interventions

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Clinical Decision Support Tool

Deliver prognostic information and evidence-based decision support at the point of care

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

Healthcare providers must meet the following criteria:

* Are an attending physician, fellow, or resident, advanced practice nurse, or physician associate
* Has ordering privileges
* Are members of one of the hospitals' admitting teams (e.g., hospitalist service, cardiology service)
* Anticipate employment at one of the two study sites for the 15-month trial period.

Or

* Palliative care team member
* Hospital administrator/quality and safety personnel

Patients of providers enrolled in the study must meet the following criteria for heart failure during hospitalization:

* N-terminal pro-B-type natriuretic peptide values of \>500 pg/ml
* Not pregnant at the time of admission.
* Received intravenous diuretics within 24 hours of admission.